Two Ebola victims are scheduled to arrive in Atlanta today at Dobbins AFB. From there they will be transferred across town to Emory Hospital near the CDC.

That was an unsettling news story to read with my morning coffee. Both sites are less than an hour away. Scenes from The Walking Dead fill my brain as it screams WHY?

Why transport anyone with a contagious, lethal disease with no known cure and very few survivors away from an infected zone to an uninfected one especially considering that past outbreaks were contained by quarantine? What are these people thinking?

So far I have not found any satisfactory answers. Nothing about a nifty new treatments to test under controlled conditions. Nothing about not needlessly endangering valuable epidemiologists and other suitably-trained medical personnel. In fact, the opposite. The CDC is sending even more aid workers to West Africa. Some will likely catch the virus. Will they too then be brought back here for treatment?

Too soon to panic? Probably, but my fears are not centered on me but on a bright, happy two-year old in my life and his mother who works in a pharmacy near the hospital.

Comments

I assume they are bringing this health care worker back to try and save their life. I assume you are not being asked to be part of the team caring for this individual?

'Quarantine' or isolation, does not normally have to be on a continental scale. This individual will be isolated and should not be a threat, and the team caring for them will I am sure be monitored closely.

Try to have some confidence. The history of deadly communicable diseases is long and varied, and we should always remember those who, far braver than most of us, ran a deadly risk in identifying lethal pathogens, and their life cycle, and/or helped develop vaccines.

You obviously have more confidence in the current state of health care than I do. That's okay. Mine was totally annihilated by up close contact from 1997-2000, some of it at Emory.

There's also the omission in the first articles of a definitive reason to transfer them here. It's mostly just endless comments about how much effort is going into making the transfer safe. One even quoted a CDC official saying transporting deathly ill people usually causes more harm than good.

My admittedly cynical guess is that one of them is from an influential family or organization. Whichever one accepted the experimental treatment of a blood donation from an Ebola survivor may have some small scientific validation.

The thing is that we have capabilities that did not exist in the past to go in force, medically speaking, and contain a disease where it is. Why risk a trans-Atlantic flight that is not even in the best interest of the patient?

Ebola is already in this country and has been here several decades. Ft. Detrick, MD has had it for a long time in a Biosafety level 4 unit at the USAMRIID's facility. They have been working on a Vax because they consider it a biological warfare threat. CDC in Atlanta also has it as well other BSL4 facilities. The European(ECDPC) and Chinese equivalent to our CDC is also working on this epidemic.

Emery University Hospital has a unit set up for level 4 contagions. That special jet didn't just get commissioned. Emery receives patients more often then you realize in that unit. They are flown in by special transport. This is not their first rodeo.

Instead of me writing a long explanation of the disease you can read it here:

I just spent the last couple of hours trying to find something on the internet that was not on white paper level so it could be understood by everyone. It is late and I will be out of town for the next 5 days and I didn't want to leave this unanswered. I have been following this story since the outbreak started.

You think I did not read all this and more of this before I wrote -- plus I remember the Reston outbreak, as should you. It caused a bigger media panic over a lot less than is happening now.

Not sure if it was then or when knowledge of AIDS first erupted that Scientific American had an excellent article on pandemics and how some of our most annoying commonplace diseases were initially extremely lethal but their spread was constrained by geography while either non-lethal strains evolved or it died out completely. It may be archived online. I don't know. I haven't looked.

Something I thought about after replying above. Why are you so blasé about a risk that has the potential to virtually destroy populations (est. 90% mortality) in a very short time span but quite hyperbolic about the slow-boil-frog threat of Climate Change? What warrants your confidence in our ability to cope with one but not the other? This is a sincere question. It baffles me.

We should not be concerned about the two people that we're bringing to this country that we already know have Ebola, but rather about the possible visitors to our country that have Ebola but do not know it. I have the utmost confidence in the CDC's ability to quarantine these two victims.

Yes, stealth infection is a greater threat but the risk level is not what bothers me as much as the pointlessness of it. Why take the risk it at all? It's one of those low probability - high consequence things I wish people would think harder about.

If we face the prospect of stealth infection, it is probably wise to evaluate the disease under a controlled environment. Infectious disease specialists may be able to develop vaccines or other therapies.

We have the capability to provide a controlled environment at the epicenter of infection. Outfit some containers with necessary equipment and supplies and transport them there rather than contagious patients to uninfected areas.

BTW, do you think a suitably-equipped container would have been a been a better isolation chamber than what was used on these flights?

I think the biggest transmission risk is via contact with body secretions and fluid. The other risk I appears to be contaminated household utensils and medical equipment. The plastic covering may be all that was required for transport if fluids and secretions are handled properly. For long term care isolation makes sense.

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